title: Real-time image-guided recontouring in the management of craniofacial fibrous dysplasia.
abstract: OBJECTIVE
  This report presents our experience using computer-aided recontouring in the surgical management of complex craniofacial fibrous dysplasia with the use of a navigation system developed by the authors.
  
  
  METHODS
  A total of 21 patients (9 men and 12 women) with craniofacial fibrous dysplasia and mean age of 23 years (range, 17-32 years) were included in this study from 2007 to 2012. By creating a mirror image of the unaffected side on the affected side as a virtual treatment template, we completed the recontouring procedures in real time with the aid of the navigation system that we developed (Accu-Navi). The surgical outcome was assessed by superimposing the postoperative computed tomography (CT) images onto the preoperative CT images.
  
  
  RESULTS
  The precise preoperative simulation and intraoperative navigation enabled the surgeon to complete the recontouring procedure visually. Postoperative CT was compared with the preoperative plan, yielding an average discrepancy of <1.0 mm. Postoperative follow-up found that both facial aesthetics and patient satisfaction improved remarkably.
  
  
  CONCLUSIONS
  Navigation-guided recontouring shows benefits in improving accuracy and safety for this complicated procedure.
authors.affiliation: Associate Professor, Department of Oral and Maxillofacial Surgery, Ninth People's Hospital, affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
authors.forename: Haijun
authors.initials: H
authors.lastname: Gui
authors.forename: ShiLei
authors.initials: S
authors.lastname: Zhang
authors.forename: Steve G F
authors.initials: SG
authors.lastname: Shen
authors.forename: Xudong
authors.initials: X
authors.lastname: Wang
authors.forename: Joy S
authors.initials: JS
authors.lastname: Bautista
authors.forename: P J
authors.initials: PJ
authors.lastname: Voss
mesh_terms: D000293:Adolescent; D000328:Adult; D019465:Craniofacial Abnormalities / Q000000981:diagnostic imaging / Q000601:surgery*; D005146:Facial Asymmetry / Q000000981:diagnostic imaging / Q000601:surgery; D005147:Facial Bones / Q000000981:diagnostic imaging / Q000601:surgery; D005260:Female; D005357:Fibrous Dysplasia of Bone / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D021621:Imaging, Three-Dimensional; D008297:Male; D019651:Plastic Surgery Procedures / Q000379:methods*; D025321:Surgery, Computer-Assisted / Q000379:methods*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome